Interactive session: Preparing for the next global health panic

Davos, Switzerland
27 January 2005

What is an appropriate risk threshold?

These are the triggers for WHO declaring an emergency - the criteria according to which a situation is declared an emergency. Triggers can include:

  • large numbers of lives lost or threatened in several countries;
  • large numbers requiring life-saving treatment;
  • need for extensive non-routine disease-prevention measures;
  • need to restore health infrastructure, which includes water, sanitation, nutrition, immunization and health services;
  • need for post-traumatic stress disorder care, child care, care for vulnerable groups.

Outline examples from WHO's recent experience: SARS, "3 by 5", the tsunami.

Other reference points (e.g. recent and current avian influenza alerts, Ebola, mad cow, anthrax, Chernobyl (1986), Bhopal (1984).

What measures should be taken?

WHO has taken the following measures:

  • The new WHO Strategic Health Operation Centre (SHOC) - a state-of-the art communication technology in a fully secure environment.
  • A well-tested intelligence system, gathering information from Member States, the Web and from formal and informal networks.
  • Global network for rapid verification with countrie's health authorities, access to the best scientific expertise, and timely response.
  • Development of specific diagnostic and intervention tools (e.g. non-commercially available specific diagnostic reagents).
  • Strategic vaccine stockpiles for meningitis, yellow fever, smallpox and the same for polio in post-eradication.
  • Maintenance of various international expert panels and the ability to rapidly convene scientific meetings in Geneva, or via telephone or video-conferencing (e.g. influenza vaccine composition meeting, SARS laboratory and epidemiology working groups set up at the time of the SARS epidemic).
  • Working closely with Member States to revise the International Health Regulations which will set up the ground-rules between WHO and its Member States, should a global public health emergency arise.

Note: none of these measures mean anything unless clear lines of coordination are established early on. Without that, any response, however big and quick, is a mess.

How much will it cost and where will the money come from?

  • You have to spend more money on preparation, or much of what is spent on action is wasted.
  • The idea is to build up enough cash on hand so that rapid health assessment teams can be equipped and ready to go within three hours of an emergency being declared - not three days, as in the case of the tsunami.
  • The International Health Regulations can help to define the arrangements and procedures needed, the relevant authorities and their responsabilities.